P8-2 Rezum water vapour thermal therapy for benign prostatic hyperplasia: early results from the United Kingdom Max Johnston1, Tina Gehring1, James Montgomery1, Govindaraj Rajkumar1, Amr Emara1, Tim Nedas1, Hashim Ahmed2 and Richard Hindley1 1Hampshire Hospitals NHS Foundation Trust, United Kingdom 2Imperial College London, United Kingdom Introduction The management of symptomatic BPH is evolving and now includes several minimally invasive therapies which aim to improve urinary symptoms whilst maintaining a low likelihood of side-effects. Resection, vapourisation and enucleation of prostate tissue allow for maximum tissue removal with excellent symptomatic benefit, but with a not insignificant risk of sexual dysfunction and incontinence. Furthermore, the side-effects of BPH medication may have been under-estimated and some men would prefer to avoid taking medication. Rezum is a novel interstitial therapy for BPH which uses convective heating to ablate prostate tissue. The 3-year results from a prospective randomised US trial have demonstrated encouraging and durable results with preservation of sexual function. It is quick and can be performed under local anaesthetic. This project aimed to report on the results of the first case series of Rezum water vapour therapy in the UK. Results Pre-treatment 1 month post DEMOGRAPHICS AND PATIENT CHARACTERISTICS 55 procedures under local anaesthetic with sedation Mean age=65.5 years Mean prostate volume=51.5ml (20-110) 5 patients in retention/CISC Mean operative time=17.5 minutes Mean number of treatments=5 66% had median lobe treatment OUTCOMES No change in erectile function Moderate symptomatic improvements at 4-6 weeks Significant (P<0.01) improvements in flow rate, PVR, IPSS, QoL and prostatic volume at 3 and 6 months 36% mean volume reduction at 6 months 80% passed first TWOC 97% catheter free at 3 months 3 overnight stays (2 social) Length of follow-up Number of patients Baseline 79 4-6 weeks 61 3 months 41 6 months 19 12 months 5 Conclusions Rezum is an exciting new minimally invasive treatment option for men wishing to preserve sexual function Rezum significantly improves urinary symptoms at 6 months These UK results are in line with the US experience of over 25,000 cases This procedure can be reliably performed as a day-case procedure under local anaesthetic with sedation It is a versatile procedure which is suitable for patients with obstructing median lobes and gland volumes of up to 100 mls It would also appear to be an option for those men with retention of urine but further studies are required Further analysis of cost-effectiveness and comparison to other BPH treatments are underway Rezum should be considered as an alternative to both medication and established day-case treatment options for men with symptomatic BPH Method This study was a prospective case series in two institutions in the United Kingdom. 79 men underwent convective radiofrequency thermal therapy to the prostate. Each 9-second treatment was delivered systematically based on both prostatic volume estimation and endoscopic appearances. Men were diagnosed and selected for treatment using uroflowmetry, IPSS questionnaires, PSA testing and selected patients underwent prostatic volume estimation or urodynamics. Patients with retention and large median lobes were included. Patients were offered general anaesthetic or local anaesthetic with sedation. Follow-up was carried out at 4-6 weeks, 3 months, 6 months and is planned for 12 and 24 months. At follow-up outcomes recorded were flow rate, post void residual, IPSS and IIEF-5 questionnaires, prostatic volume estimation, use of new or pre-existing medications, success of trial without catheter and post-operative complications. Analysis reports the above outcomes for patients at each stage of follow-up. This is ongoing work so analysis was only conducted for patients with complete data at each stage of follow-up. Complications Nature Clavien-Dindo Grade n UTI 2 4 Return to theatre for secondary haemorrhage 3b Return to theatre for TURP 1 References Mynderse L et al. Urology. 2015;86(1):122-127. McVary KT et al. Urology. 111;1-9, 2018. McVary K et al. J Sex Med. 2016. Jun;13(6):924-33. Dixon C et al. Res Rep Urol. 2016:8;207-16. McVary KT et al. Urology. 2018 Jan:111;1-9. Ulchaker et al. Clinicoecon Outcomes Res. 2018;10:29-43. CONTACT INFORMATION maxj101@gmail.com